ABSTRACT
We have studied the placement of three screws within the femoral head and the degree of angulation of the screws in 395 patients with displaced intracapsular fracture of the hip to see if either was related to the risk of failure of the fracture to unite. No relationship between nonunion of the fracture was found regarding the position of the screws on the anteroposterior radiograph. However, we found that a reduced spread of the screws on the lateral view was associated with an increased risk of nonunion of the fracture.
Subject(s)
Bone Screws , Femoral Neck Fractures/surgery , Fracture Fixation, Internal/methods , Fractures, Ununited/surgery , Adult , Aged , Aged, 80 and over , Female , Femoral Neck Fractures/diagnostic imaging , Femur/surgery , Fractures, Ununited/diagnostic imaging , Hip Joint/surgery , Humans , Male , Middle Aged , Radiography , Risk Factors , Treatment FailureABSTRACT
BACKGROUND: War wounds produce a significant burden on medical facilities in wartime. Workload from the recent conflict was documented in order to guide future medical needs. METHODS: All data on war injuries were collected prospectively. This information was supplemented with a review of all patients admitted during the study period. RESULTS: During the first 2 weeks of the conflict, the sole British field hospital in the region received 482 casualties. One hundred and four were battle injuries of which nine were burns. Seventy-nine casualties had their initial surgery performed by British military surgeons and form the study group. Twenty-nine casualties (37 per cent) sustained gunshot wounds, 49 (62 per cent) suffered wounds from fragmentation weapons and one casualty detonated an antipersonnel mine. These 79 patients had a total of 123 wounds that were scored prospectively using the Red Cross Wound Classification. Twenty-seven (34 per cent) of the wounded were non-combatants; eight of these were children. Four patients (5 per cent) died. CONCLUSION: War is changing; modern conflicts appear likely to be fought in urban or remote environments, producing different wounding patterns and placing non-combatants in the line of fire. Military medical skills training and available resources must reflect these fundamental changes in preparation for future conflicts.
Subject(s)
Warfare , Wounds, Penetrating/epidemiology , Abdominal Injuries/epidemiology , Adolescent , Adult , Amputation, Surgical/statistics & numerical data , Blast Injuries/epidemiology , Child , Child, Preschool , Craniocerebral Trauma/epidemiology , Female , Humans , Infant , Injury Severity Score , Iraq , Kuwait/epidemiology , Male , Middle Aged , Neck Injuries/epidemiology , Prospective Studies , Thoracic Injuries/epidemiology , Wounds, Gunshot/epidemiologyABSTRACT
A case is reported of cardiac arrest in a young man after an armoured vehicle rollover accident. The proposed mechanism of death is myocardial sensitisation to endogenous catecholamines after exposure to petroleum fuel.
Subject(s)
Death, Sudden/etiology , Gasoline/poisoning , Inhalation Exposure/adverse effects , Military Personnel , Accidents, Traffic , Adult , Autopsy , Fatal Outcome , Humans , Male , United KingdomABSTRACT
The Thomas splint was developed for the stabilisation of femoral fractures at the end of the nineteenth century, and since the First World War has been extensively used by the British Army. It has been shown to improve the outcome after ballistic fractures of the femur, but recently there have been moves to abandon this device in favour of more modern splints such as the Sager splint. This is predominately due to the ease of use and smaller size of newer devices, which makes them more suitable for the pre-hospital environment. However, we present our experience of managing both ballistic and closed femoral injuries using Thomas splints during the recent Gulf Conflict. It is our belief that the Thomas splint is an essential tool in the management of military femoral injuries at role three facilities and must be retained.
